Immunohistochemical identification of lymphatic vessels in the periodontium of equine cheek teeth

Immunohistochemical detection of lymphatic capillaries was performed in the periodontium of maxillary and mandibular cheek teeth from 6 horses (aged 3-23 years). Tissue sections of the periodontium were taken at 4 different horizontal levels along the long axis of the tooth. The specimens were processed for immunoreaction with anti-Prox1, in order to distinguish lymphatic endothelium from blood vascular endothelium. Lymphatic vessels were detected in all periodontal tissues except for the dental cementum. Lymphatic capillaries were most densely distributed in the gingiva compared to other tissues of the periodontium. Lymphatic capillaries were found most consistently in samples taken from the gingival and subgingival regions in all horses examined. Within these levels, the gingiva as well as the spongiosa of the maxillary and mandibular bone had the greatest incidence of lymphatic vessels. Considering the distinct distribution of the lymphatic capillaries in the periodontium of the maxillary and mandibular cheek teeth, two complementary lymphatic drainage pathways are proposed: (1) superficial lymph drainage via the gingiva, emptying into the mandibular lymph nodes; (2) deep lymph drainage via the mandibular and maxillary spongiosa, emptying into the mandibular and retropharyngeal lymph nodes, respectively.     

Diagnostic value of the use of lateral and occlusal radiographic views in comparison with periodontal probing for the assessment of periodontal attachment of the canine teeth in dogs

OBJECTIVE: To determine the diagnostic value of 2 intraoral bisecting angle radiographic views in comparison with periodontal probing for the assessment of periodontal attachment of the canine teeth in dogs. STUDY POPULATION: 466 canine teeth from 117 dogs. PROCEDURE: Periodontal probing measurements were recorded, and clinical attachment levels (CAL) were calculated at the mesial, buccal, distal, and lingual (or palatal) surfaces on each canine tooth. Occlusal and lateral radiographs of the canine teeth were obtained. Alveolar margin height (AMH) was measured at the same 4 surfaces. Values for AMH and CAL were compared on the basis of tooth surface, dental arch, and radiographic view. RESULTS: The AMH at the mesial and distal surfaces of the mandibular canine teeth was measurable on the lateral view and was significantly correlated with CAL. Similar results were found for the mesial and distal surfaces of the maxillary canine teeth. Buccal and lingual AMH were measured on the mandibular occlusal radiographic view, and values were significantly correlated with CAL, but only the buccal AMH could be assessed on the occlusal radiographic view of the maxilla with values that correlated significantly with CAL. CONCLUSIONS AND CLINICAL RELEVANCE: The lateral radiographic view is suitable for evaluating periodontal attachment at the mesial and distal surfaces of the canine teeth in dogs. The occlusal radiographic view is suitable for assessing buccal surfaces as well as the lingual surface of mandibular canine teeth but not the palatal surface of maxillary canine teeth in dogs.     

Evaluation of periodontal changes following intra-alveolar prosthesis for maxillary cheek tooth extraction in ponies

This study investigated the placement of an intra-alveolar prosthesis of bone substitute on gingival/periodontal health in 5 ponies following repulsion of cheek teeth 108 and 208. In each pony, one randomly chosen alveolus was allowed to heal by second intention while the other was filled with a non-resorbable, biocompatible bone substitute. At 6, 12 and 24-months after surgery, both maxillary arches were evaluated for wear abnormalities and for gingival health using a periodontal scoring system. Recorded changes included development of overgrowths on mandibular cheek teeth, widening of maxillary interproximal spaces due to tooth drift with subsequent food accumulation, gingivitis, and subgingival pocket formation. Diastema formation initially occurred between the maxillary 06 and 07s but resolved after 24-months, whereas the diastemata that developed between the maxillary 09 and 10s remained. It was concluded that maxillary cheek teeth extraction induced progressive changes in the position of adjacent teeth that caused periodontitis. The use of a bone substitute prosthesis in the alveolus did not prevent the development of periodontal disease.     

Occlusal angles of cheek teeth in normal horses and horses with dental disease

The angle between the occlusal surface of the tooth and the horizontal plane of 687 cheek teeth from the skulls of 22 horses without gross dental disorders and 11 horses with dental disorders were measured by using stiff malleable wire as an imprint. Each measurement was repeated five times and the mean angle was recorded. In the normal skulls, the mean occlusal angles of the mandibular cheek teeth ranged from 19.2 degrees at the Triadan 06 position to 30 degrees at the 11 position, and these angles were significantly greater than the occlusal angles of the opposing maxillary cheek teeth (range 12.5 degrees to 18 degrees) at all the positions except the 06. The rostral mandibular cheek teeth had significantly lower occlusal angles than the caudal mandibular cheek teeth, but the converse was true for the maxillary teeth. In the skulls with dental disorders the occlusal angles of the mandibular cheek teeth ranged from 15.6 degrees to 28.5 degrees , and of the maxillary cheek teeth from 9.2 degrees to 16.4 degrees. They were not significantly different from the angles of the teeth from the normal skulls, except at the 06 position, where they were smaller.     

A post-mortem study on the prevalence of peripheral dental caries in Scottish horses

Peripheral caries (PC) is an increasingly recognised equine dental disorder with unknown predisposing factors that differs from the well described maxillary cheek teeth infundibular caries. Advanced PC can lead to premature wear and fracture of cheek teeth and thus is of welfare importance. Recent studies have shown large variation in the prevalence of PC in different European countries, with a trend towards a greatly increasing prevalence. One hundred and one equine heads sourced from a Scottish rendering plant were examined for the presence and grade of PC using the modified Honma equine dental caries grading system. The presence of cheek teeth calculus, diastemata and fractures was also recorded. Peripheral caries was present in 91% of horses; only affected the cheek teeth and was predominantly (72.6%) Grade 1 Class 1 (localised pitting lesions only affecting cementum). The caudal three cheek teeth were more commonly affected (74.7% prevalence) as compared to the rostral three cheek teeth (32.1% prevalence). The palatal aspect of maxillary and the buccal aspect of mandibular cheek teeth were significantly (245% and 170%, respectively) more commonly affected by PC than the opposite sides. Female horses were more commonly affected than males. Because post-mortem examination allows the most detailed oral examination to be performed, this may partly explain the higher PC prevalence found in the current, as compared to previous studies, in addition to the particular population examined in this study.     

Occlusal fissures of the equine cheek tooth: Prevalence,location and association with disease in 91 horses referred for dental investigation

Reason for performing study: Fissures of the occlusal surface of the equine cheek tooth are poorly understood and their association with dental disease is unknown. Objective: To describe the prevalence and location of occlusal fissures in the cheek teeth (CT) of a group of horses referred for dental investigation/treatment, and determine association with intercurrent dental disease. Methods: Digital video recordings of oral endoscopic examinations for all horses referred to the Rossdales Equine Hospital for dental investigation from November 2006 to June 2009 were reviewed. Location of occlusal fissures in relation to both Triadan tooth position and pulpar secondary dentine was recorded; direction of fissure and concurrent involvement of enamel was also documented. The CT location considered at the time of examination to be the primary site/s of disease was correlated with presence of fissures on these teeth. Results: 91 cases meeting the inclusion criteria were identified. Occlusal fissures were documented in 58.2% (53/91) cases, with a total of 227 CT being affected. Fissures were most prevalent mid‐arcade. The majority (92.1%) of fissures in maxillary CT were associated with the caudal palatal pulp horn. Fissures in mandibular CT were predominantly associated with the buccal pulp horns (95.7%). There was no significant difference in the median number of CT with fissures in relation to gender. There was no correlation between age (r²= 0.01) of horse and number of CT with fissures. A significantly greater number of CT with multiple occlusal fissures was found in mandibular compared to maxillary arcades. No correlation was found between presence of fissures and location of individual CT considered to be primarily responsible for presentation. Conclusions: Occlusal fissures in this group of animals were common and not correlated to primary site of dental disease. Potential relevance: In horses subjected to dental investigation, occlusal fissures of the cheek teeth should not be considered an indicator of tooth compromise. Location and direction of fissure propagation in most cases is inconsistent with occlusal fissures being causally implicated in slab fractures of cheek teeth, although site predilection may indicate a possible association with masticatory forces.     

Observations of the cheek tooth occlusal angle in the horse

The angle of occlusion was evaluated in 230 mandibular cheek teeth from 21 horses. There was no significant relationship between horse condition (sedated, anesthetized, dead) and measurement of mean cheek tooth occlusal angle. Cheek tooth occlusal angle was not significantly affected by the position of the tooth in the mandibular arcade or tooth age. The measurement of individual mandibular cheek tooth occlusal angles was predictive for occlusal angle of the entire mouth. Multiple variations of the incisor separation angle technique were predictive of cheek tooth molar occlusal angle for the measured arcade and the entire mouth but was significantly different contralaterally, suggesting that the single tooth method may be preferred. However, despite the limitations of the relatively simple incisor separation angle technique, it may provide the equine veterinary dentist a rapid method of assessing cheek tooth occlusal angle to ensure proper dental floating methods and outcomes.     

Measurement of clinical crown length of incisor and premolar teeth in clinically healthy rabbits

The clinical crown length of rabbit teeth has not been well documented. The aim of this study was to determine the clinical crown length of incisor and cheek teeth, and the periodontal probing depth in young healthy rabbits without clinical signs of dental disease. Two groups of 20 male rabbits were measured, the first in 2007 and the second in 2008/2009. The measurements were taken with rabbits under general anesthesia using a periodontal probe. The average crown length (mm) of the mandibular third and fourth premolar, and maxillary second premolar teeth was 3.1 +/- 0.4, 2.6 +/- 0.4, and 1.5 +/- 0.4, respectively. The periodontal probing depth for the cheek teeth in the maxilla and the mandible was very similar (0.5 - 1.0-mm). There was a minor difference in the average crown length (mm) of the mandibular (6.4 +/- 0.6) and maxillary (6.1 +/- 0.9) incisor teeth. The periodontal probing depth (mm) was different when comparing maxillary (2.2 +/- 0.4) and mandibular (5.1 +/- 0.8) incisor teeth. The divergence in tooth length in individual rabbits and between the two groups was minimal. Measuring the crown length of the rostral cheek and incisor teeth with a periodontalprobe is easy to do in the rabbit and should be integrated into the clinical examination. The measurement results of this study can be used as a reference when trimming teeth.     

The prevalence of secondary dentinal lesions in cheek teeth from horses with clinical signs of pulpitis compared to controls

Reasons for performing study: With the advent of detailed oral examination in horses using dental mirrors and rigid endoscopy, secondary dentinal lesions are observed more frequently. More information regarding the association of secondary dentinal defects with apical dental disease would improve the sensitivity of oral examination as a diagnostic aid for pulpitis. Objectives: To assess prevalence and severity of secondary dentinal defects observed on examination of occlusal surfaces of cheek teeth (CT) from horses showing clinical signs of pulpitis compared to asymptomatic controls. Methods: Records from all cases of equine CT exodontia at the University of Bristol over a 4 year period were examined. Case selection criteria included the presence of clinical signs of pulpitis, an intact extracted tooth and availability of a complete history and follow up. Cases where coronal fracture or periodontal pocketing featured were excluded. CT from cadavers with no history of dental disease served as normal controls. Triadan positions and eruption ages of control teeth were matched with those of teeth extracted from cases. CT from selected cases and control teeth were examined occlusally. Secondary dentinal defects were identified and graded. Prevalence of occlusal lesions in CT with pulpitis and controls was compared. Results: From the records of 120 horses where exodontia was performed, 40 cases matched selection criteria. Twenty‐three mandibular and 21 maxillary CT were extracted from cases. The controls consisted of 60 mandibular and 60 maxillary CT from 7 cadaver skulls. Secondary dentinal defects were significantly over‐represented in CT extracted from cases of pulpitis (P<0.001). Of diseased mandibular CT, 56.5% had defects compared to none of the controls. Of diseased maxillary CT, 57% had defects compared with 1.6% of controls. Multiple defective secondary dentinal areas and severe lesions were more prevalent in diseased mandibular CT compared with diseased maxillary CT. Conclusions and practical significance: Careful examination of occlusal secondary dentine is an essential component in investigation of suspected pulpitis in equine CT.     

The incidence and distribution of peripheral caries in the cheek teeth of horses and its association with diastemata and gingival recession

Although considered relatively common in horses, there is little information on the prevalence, distribution and aetiology of peripheral caries of the equine cheek teeth (CT). The objective of this study was to investigate a possible association between this lesion and diastemata or 'gaps' between the CT which facilitate the entrapment of food material. Video recordings of oroscopic examinations of all dental cases at an equine hospital over a 3-year period were reviewed, and the location of all diastemata, peripheral caries, trapped food, and of gingival recession were recorded. A total of 108 cases met study inclusion criteria and 298 diastemata and 445 CT with peripheral caries were noted. Diastemata were found predominantly in the mandibular arcades (80%) and 75% of animals had at least one diastema. Peripheral caries was uniformly distributed between the maxillary and mandibular CT, being most prevalent on the most caudal three teeth (87%). Overall, diastemata were not associated with peripheral caries at either a tooth or individual patient level. However, a highly significant association was found between the presence of trapped food within diastemata and gingival recession.     

Quantitative and qualitative assessments of intraoral lesions in 180 small herbivorous mammals

Between 2002 and 2005 210 rabbits, 257 guinea pigs and 123 chinchillas were examined; oral disease was diagnosed in 38.1 per cent of the rabbits, 23.4 per cent of the guinea pigs and 32.5 per cent of the chinchillas. In the rabbits, the maxillary right P3, mandibular right P3, P4 and M1 and mandibular left P3, P4, and M1 were the teeth most frequently affected; in the guinea pigs, the mandibular right P4 and both the mandibular left incisor and P4 were most often affected; and in the chinchillas the maxillary right P4 and M1 and maxillary left P4 were most often affected. The incisors and first mandibular cheek teeth of the guinea pigs were significantly more often affected than those in the chinchillas or rabbits. Bilateral lesions of the maxillary cheek teeth were significantly more common in the chinchillas. The highest incidence of gingival hyperplasia was recorded in the rabbits. The incidence of gingival erosions and gingivitis were significantly higher in the chinchillas.     

Equine dental disease part 2: a long-term study of 400 cases: disorders of development and eruption and variations in position of the cheek teeth

Of 400 referred horses with dental disorders, 349 cases suffered from primary disorders of their cheek teeth, ninety of these from disorders of development or eruption, or displacements. These included 20 cases with rostral maxillary and caudal mandibular cheek teeth overgrowths, 16 with diastemata, 15 with grossly enlarged mandibular 'eruption cysts', 4 with grossly enlarged maxillary cheek teeth 'eruption cysts', 10 cases with supernumerary cheek teeth and 23 cases with displaced cheek teeth. These displacements were believed to be developmental in 16 cases and acquired in the remaining 7 cases. Long-term response to treatments, that included removal of overgrowths and extraction of teeth with deep secondary periodontal disease was excellent for most disorders except diastemata.     

Donkey dental anatomy. Part 1: Gross and computed axial tomography examinations

Post-mortem examination of 19 donkey skulls showed that donkeys have a greater degree of anisognathia (27% width difference between upper and lower jaws) compared to horses (23%). Teeth (n=108) were collected from 14 skulls and examined grossly and by computed axial tomography (CAT). A greater degree of peripheral enamel infolding was found in mandibular cheek teeth (CT) compared to maxillary CT (P<0.001). A significant increase in peripheral cementum from the apical region to the clinical crown was demonstrated in all CT (P<0.0001). All donkey CT had at least five pulp cavities with six pulp cavities present in the 06s and 11s. A new endodontic numbering system for equid CT has been proposed. A greater occlusal depth of secondary dentine (mm) was present in older donkeys (>16 years) than in the younger (<15 years) donkeys studied. Based on gross and CAT examinations, donkey dental anatomy was shown to be largely similar to that described in horses.     

Hemisection and partial retention of carnassial teeth in client-owned dogs

Nine client-owned dogs presented with periodontally and/or endodontically involved mandibular or maxillary carnassial teeth that were either individually affected or adjacent to a jaw fracture. A total of 10 teeth were hemisected (8 mandibular first molar teeth and 2 maxillary fourth premolar teeth), and one crown-root segment was extracted for each tooth. Gingival tissues were approximated and sutured over the extraction sites, and the retained tooth portions were treated by means of standard root canal therapy or vital pulp therapy followed by standard root canal therapy. Retained crown-root segments of 2 of the 10 hemisected teeth were extracted following short- and long-term postoperative examinations due to continued periodontal complications. It was concluded that resection of a portion of a tooth can be a useful treatment for periodontally and/or endodontically involved carnassial teeth that are affected individually or located adjacent to a jaw fracture in dogs.     

The relationship of maxillary cheek tooth development to age in young Friesian cattle.

Radiographs were taken of both the right and left sets of maxillary teeth in 23 Friesian cattle of known age. The stage of development of each permanent tooth was ascertained and the degree of root resorption in the deciduous premolars was noted. All stages in individuals were later than for those of the mandibular cheek teeth except in the case of the first permanent premolar. As with mandibular cheek tooth development stages of formation occurred within certain age limits.     

Repulsion of maxillary and mandibular cheek teeth in standing horses

Objective: To report the technique and results of cheek teeth repulsion in standing, sedated horses. Study Design: Case series. Animals: Horses (n=12), ponies (6). Methods: Medical records (2006–2009) of horses that had cheek tooth repulsion while standing were reviewed. Inclusion criteria included: maxillary or mandibular cheek tooth disease diagnosed by clinical and radiographic examination where attempted oral extraction failed necessitating repulsion. Horses were sedated and a local nerve block performed. Intraoperative radiographs facilitated instrument positioning and ensured repulsion of all dental remnants. Alveolar cavities were packed postoperatively and secondary dental sinusitis treated with lavage. Results: Median horse age was 7 years (range, 1–30 years). Maxillary (n=15) and mandibular (5) cheek teeth were removed successfully. One horse was euthanatized 1 week after tooth removal because of concurrent liver disease and 10 horses (59%) had resolution of discharge after the 1st treatment; 41% of extractions required follow‐up medical or surgical treatment to resolve signs [6/12 maxillary sinusitis and 1/5 persistent mandibular drainage]. Conclusions: Standing repulsion of diseased and fractured cheek teeth is an effective means of resolving clinical signs of dental disease when oral extraction fails. Chronic sinus involvement increased the risk of postextraction surgical treatment for sinusitis.     

Repair of experimental plaque-induced periodontal disease in dogs

Forty mongrel dogs were used in this study for induction of periodontal disease by placing subgingival silk ligatures affecting maxillary and mandibular premolar teeth during a 12-month period. Experimental premolar teeth received monthly clinical, radiographic, and histometric/pathologic assessments. The results demonstrated significant increases in scores and values of periodontal disease parameters associated with variable degrees of alveolar bone loss. The experimental maxillary premolar teeth exhibited more severe and rapid rates of periodontal disease compared with mandibular premolar teeth. Histometric analysis showed significant reduction in free and attached gingiva of the experimental teeth. Histopathological examination of buccolingual sections from experimental premolar teeth showed the presence of rete pegs within the sulcular epithelium with acanthosis and erosive changes, widening of the periodontal ligament, and alveolar bone resorption. Various methods for periodontal repair were studied in 194 experimental premolar teeth exhibiting different degrees of periodontal disease. The treatment plan comprised non-surgical (teeth scaling, root planing, and oral hygiene) and surgical methods (closed gingival curettage, modified Widman flap, and reconstructive surgery using autogenous bone marrow graft and canine amniotic membrane). The initial non-surgical treatment resulted in a periodontal recovery rate of 37.6% and was found effective for treatment of early periodontal disease based on resolution of gingivitis and reduction of periodontal probing depths. Surgical treatment by closed gingival curettage to eliminate the diseased pocket lining resulted in a recovery rate of 48.8% and proved effective in substantially reducing deep periodontal pockets. Open root planing following flap elevation resulted in a recovery rate of 85.4% and was effective for deep and refractory periodontal pockets. Autogenous bone graft implantation combined with canine amniotic membrane as a biodegradable membrane was used in 18 premolar teeth and failed to improve advanced furcation defects in most teeth.     

Donkey dental anatomy. Part 2: Histological and scanning electron microscopic examinations

Ten normal cheek teeth (CT) were extracted at post mortem from donkeys that died or were euthanased for humane reasons. Decalcified histology was performed on three sections (sub-occlusal, mid-tooth and pre-apical) of each tooth, and undecalcified histology undertaken on sub-occlusal sections of the same teeth. The normal histological anatomy of primary, regular and irregular secondary dentine was found to be similar to that of the horse, with no tertiary dentine present. Undecalcified histology demonstrated the normal enamel histology, including the presence of enamel spindles. Scanning electron microscopy was performed on mid-tooth sections of five maxillary CT, five mandibular CT and two incisors. The ultrastructural anatomy of primary and secondary dentine, and equine enamel types-1, -2 and -3 (as described in horses) were identified in donkey teeth. Histological and ultrastructural donkey dental anatomy was found to be very similar to equine dental anatomy with only a few quantitative differences observed.     

A study of sub-occlusal secondary dentine thickness in overgrown equine cheek teeth

The presence of cheek tooth loss or defects, with subsequent overgrowth of the opposing teeth, is common in horses. Little is known about the factors that control the deposition of sub-occlusal secondary dentine (SO2D) in normal equine teeth, but these are likely to include stimulation of the occlusal surface. There appears to be no information on the possible alterations to this process when teeth develop overgrowths and, consequently, of the net effect on SO2D thickness caused by reduced stimulation of the occlusal surface and of absent/reduced normal occlusal wear (attrition). Knowledge of the likely thickness of SO2D in overgrown teeth may help reduce the risks of pulp horn exposure or thermal damage during therapeutic reduction of overgrowths. This study utilised 24 permanent cheek teeth (CT) with overgrowths (mean overgrowth height: 9.5 mm; range, 3.4-17.9 mm), and 18 control CT obtained from 15 horses of different breeds and ages. The thickness of SO2D was measured above 94 matched pulp horns in control and overgrown CT and showed a mean value of 12.14 mm (range 1.87-36.02 mm) in overgrown teeth and of 10.25 mm (range 2.64-17.26 mm) in controls. There was no significant difference between SO2D thickness in overgrown (mean 11.38 mm) and control (11.41 mm) mandibular CT, but SO2D was significantly thicker in overgrown (mean 12.57 mm) as compared to control maxillary (9.41 mm) CT. A comparison of SO2D thickness above the 94 matched pulp horns in overgrown and control teeth showed that 49% (46/94) of pulps in overgrown teeth had less SO2D overlying them than had control teeth. Of major clinical relevance was that the height of dental overgrowths was greater than SO2D thickness over one or more pulp horns in 14/24 overgrown teeth. Consequently, reduction of these overgrown teeth to the level of adjacent normal-height teeth would cause occlusal pulp exposure in 58% of teeth, in addition to possible thermal damage to additional pulp horns. It was concluded that equine CT overgrowths should be gradually reduced, by a few millimetres at a time, over a prolonged period.